Title: The Speakers new language

Author: Socrates of Athens

7/20/96

I. Introductiona semantic dispute

DOES THE GOP BUDGET CONTAIN MEDICARE CUTS? Incredibly, we have
been discussing this topic for almost two years now. Rarely has
a semantic dispute about a budget proposal taken on the high public
profile that has gone to this seemingly endless dispute about
the GOP Medicare program.

When the Republican Party took over Congress in January 1995,
party leaders brought forward a set of proposals that would profoundly
alter the federal budget. The party promised to balance the budget
in seven years time, while giving tax-payers a hefty tax cut.
From that day to this, the GOP proposal has been the subject of
a puzzling semantic dispute.

According to Democrats, the GOP was proposing deep cuts in
Medicare to get the budget into balance. Republicans said they
were proposing no Medicare cuts at allthat their program would
merely slow the rate at which that popular program would grow.

It has become an article of faith among GOP faithful that their
program does not call for Medicare cuts; and Speaker Gingrich
has argued more and more forcibly that Democrats are deceiving
the public when they talk about Medicare "cuts."

And so the dispute has taken a double aspect. At stake is the
public's understanding of the simplest facts about these budget
proposalsproposals which would, GOP leaders claim, produce the
first balanced budget since 1969.

But also at stake is the public's understanding of the personal
character of President Clinton, whose personal honesty has been
attacked by the Speakerattacked because he won't stop referring
to GOP Medicare "cuts."

Gingrich has attacked the president on this matter in language
that is highly unusual among major officials. Journalists have
repeatedly asked the Speaker if he is calling the president a
liar.

Though Gingrich has side-stepped direct use of the word, conservative
pundits have shown less restraint. Here for example is Mona Charen,
in a passage from a May 12 column, expressing the fairly obvious
meaning of the Speaker's repeated remarks:

[Republican leaders] failed to understand the degree to which
this president is willing to lie to win. During the budget showdowns
and the government closures, the president dominated the debate
by calling the Republican proposals "extreme" and decrying
"cuts" in Medicare. There were, of course, no cuts,
only reductions in the rate of increase...When your opponent is dishonest,
there is nothing you can do except call attention to the facts.
Speaker Gingrich has lately begun to do that, with some good results.

One of the "good results" which Charen mentioned
was the flap that occurred this past May 8, when CNN's Wolf Blitzer,
at a White House press conference, asked the president if he would
agree to stop talking about GOP "cuts." Blitzer made
it clear that he thought the use of the term was inaccurate, and
ought to stop.

IT MAY SEEM HARD TO BELIEVE that this dispute has gone on for
two full years now. After all, the GOP budget is a public document,
not some secret text in a cave. And the GOP's proposals have been
widely discussed since the 1994 elections.

Surely by now we could expect to agree on whether the GOP was
calling for increases or cutsespecially when the president's
character has been challenged in so aggressive a manner.

It is also surprising that this confusion could persist because
the policy matter involved is so significant. We are not talking
about some obscure bill, after all. We are talking here about
entitlement reform, one of the most important issues Americans
will confront in the next several decades.

No one doubts that, with the baby-boomers' retirement, major
changes will have to be made in the big federal entitlement programs.
It is truly remarkable that, two years into our discussion of
such a topic, we cannot even agree whether the Republicans are
prescribing a Medicare increase or cut. If this is the greatest
clarity we are able to achieve in talking about our entitlement
programs, we are in for some frustrating times ahead as these
programs face major review.

Our fiscal future plainly depends on a successful review of
these entitlement programs; yet it is as if the parties are speaking
two different languages in our endless debate about Medicare reform.
We cannot afford to spend the next two decades as we've spent
these past two years, embroiled in worthless semantic disputes
that keep us from factual clarity.

In a semantic dispute, people believe they are arguing issues
of fact when they are actually arguing matters of languagearguing
favored ways to describe basic facts which are in principle open
to view. The way to resolve a semantic dispute is to look for
simpler ways to describe those factssimple ways to describe the
basic facts with which no one could sensibly disagree.

In this article, I will show how we can re-create a common
language for discussing the basics of Medicare budgeting. And
a review of the ongoing semantic wars will help us evaluate our
political leadersand will shed light on the Speaker's attack
on Clinton's character for his discussion of "Medicare cuts."

We'll be discussing these topics for the next twenty years.
It will help if we speak the same language.

II: Newt speaksand the press corps listens

President Clinton talked about Medicare cuts [in the GOP budget].
There are no Medicare cuts. We increase Medicare from $4800 per
senior citizen [in 1995] to $6700 per senior citizen [in 2002].
That's a $1900 a year increase. That's an increase, that's not
a cut.
Newt Gingrich, The NewsHour with Jim Lehrer, 11/14/95

Anyone who has followed the two-year long Medicare discourse
has seen the Speaker make some form of this argument, in which
he compares present spending with proposed future spending to
prove that there are no "cuts" in the GOP Medicare plan.
Over the past two years, Gingrich has made this argument in every
conceivable forum, often condemning Clinton's dishonesty for referring
to GOP "cuts."

On its face, the Speaker's argument seems persuasive. And,
over time, the argument has proven persuasive, to a significant
segment of the public, and to substantial segments of the Washington
press corps.

Over the past two years, anyone who has watched C-SPAN or listened
to talk radio has heard callers argue the Speaker's line. Among
GOP true believers, "there are no cuts" has become a
mantra as they have rallied behind the Speaker's program, and
as they have continued to demonize President Clinton as someone
whose word cannot be believed.

Some have fervently embraced the Speaker's program because
it offers such a pleasing picture of the future. Indeed, if we
are to take the Speaker's words at face value, happy days are
just seven years away.

According to the Speaker's argument, if we adopt the GOP plan
we will balance the budget, and we'll get a big tax cut, and our
entitlements will "increase" by 40%! People who have
taken the Speaker's words at face value have embraced the miracle
vision he offers, and have lashed out at others who seem prepared
to derail this marvelous plan.

But the truth is substantially different. However self-evident
the Speaker's argument may seem, and however widely the public
may have embraced it, his argument is in fact deeply flawed, and
has profoundly affected the public's ability to conduct a clear
Medicare discourse. In arguing as he has done, Gingrich has not
merely damaged the discourse, as he is wont to do, by demonizing
opponents in the most personal manner. He has also presented a
profoundly misleading analysis, which has badly confused substantial
segments of the public about the fundamental nature of his budget
proposal. And, by brow-beating and bullying a Washington press
corps that has proven cravenly compliant and technically incompetent,
he has stage-managed our Medicare discourse in a masterful wayimpairing
our ability to understand an issue that will be crucial for the
next twenty years.

The conceptual chaos that has come from Gingrich's argument
has thrown our Medicare discourse into a state of disarray. To
untangle the confusion, we must go back and see what is wrong
with the arguments Gingrich has made.

Let's start our critique of the Gingrich Comparison by noting
that the Speaker's numbers are perfectly accurate. The federal
government did spend $4800 per Medicare recipient in 1995,
and the GOP, in November 1995, was proposing to spend $6700
per recipient in the year 2002. (Late in November 1995, their
proposal rose to $7100 per recipient in 2002.)

Nor can the Speaker's subtraction skills be impeached; had
the GOP plan been enacted we would have been spending $1900 more
per recipient in 2002 than we had spent in 1995. And that would
have been the "40% increase" in dollar spending Gingrich
sometimes cited in his pitch for the plan.

But what is wrong with the Gingrich Comparison is just as striking
as his mastery of basic math. In his presentation, the Speaker
compares budget numbers across a seven-year time span without
making any attempt to account for inflation. Even when done in
good faith, this is a bone-headed Budget 101 error, universally
guaranteed to mislead.

At the time that the Speaker was appearing on the NewsHour,
for example, the Congressional Budget Office was officially estimating
that it would cost around $8000 per recipient to maintain the
current Medicare program in 2002, far more than the $6700 the
GOP was proposing to spend. When this third figure is considered
along with the pair of figures that make up the standard Gingrich
Comparison, the Speaker's cheerful presentation suddenly takes
on a distressing new aspect.

Where once it seemed we were discussing a massive, unambiguous
"growth in the Medicare program," with attendant rise
in Medicare services, now a rational person will inevitably wonder
if it will be possible to maintain current service levels at the
future spending the GOP would provide. If it would cost $8000
per recipient to run the current program in 2002, what level of
services can the Speaker provide for $1300 less? Will he be able
to maintain current services, or will he have to scale them back?
There is no way to answer this basic question from the pair of
numbers that make up the Gingrich Comparison. And because Gingrich
neglects to mention the $8000 figure that tells us what the current
program would cost in 2002, a misimpression is lodged in the minds
of the public, most of whom are not trained budget analysts, that
a massive "growth" in Medicare services is being
discussed, when no such proposal has ever been made by the Republican
Party at all.

I note, by the way, that the average citizen is not a trained
budget analyst, but the same cannot be said of Speaker Gingrich,
who has worked with federal budgets for the better part of his
adult life. He knows perfectly well what the typical citizen may
notthat no one would ever construct a federal budget in the way
the Speaker is doing here, comparing budget figures across lengthy
time spans without accounting for inflation at all.

Indeed, the analyst's tool that is called "constant dollars"
was devised just to deal with this kind of problemto avoid the
misunderstandings that inevitably arise in comparing budget figures
from different years. By using constant dollars, or by accounting
for inflation in some other way, budget analysts, every day, work
to avoid the kind of confusion that Gingrich built into the misleading
argument he has made over the past several years.

And it is now quite clear that the Speaker's argument has created
giant confusion. It is hard to listen to today's Medicare discourse
without hearing the fundamental misunderstandings that have been
caused, completely predictably, by the Gingrich Comparison.

For example, here is a caller to Tim Russert's CNBC talk show
on December 12, 1995. She alludes directly to a common part of
the GOP Medicare argument, and the confusion that results is quite
plain:

RUSSERT: Let's go to the phones. Tennessee! Sandra, you have
a question?

CALLER: Yes. In a recent Wall Street Journal poll, the majority of people, when asked, thought the Republicans were actually cutting Medicare. When they were informed that Medicare was rising by 47%, they indicated that they thought that by 60%, that they thought that was too much. When is the press going to start telling the American people what's really happening? And if they don't, how can we say we're having fair elections?

But when respondents were told that "Medicare was rising
by 47%," did they realize it was Medicare dollar spending,
unadjusted for inflation, that was rising by that amount, and
that the rate of rise was substantially less, over seven years
time, than it would take to keep running the current Medicare
program? The ambiguous phrase "Medicare is rising by 47%"
inevitably conjures a picture of more and more federal bureaucrats
doling out more and more Medicare services; but what is
actually being discussed here is Medicare dollar spending,
unadjusted for inflation, a figure from which we cannot determine
the fate of Medicare services. The caller shows the way in which
people were being misled by the Gingrich Comparison, with its
studied failure to mention inflationhow they thought they were
getting so much more in services under the GOP plan that they
were announcing their intention to give some of it back, not realizing
that the real question they should have been asking was whether
it would be possible to maintain the current level of services
at the spending level the Speaker proposed. In the year 2002,
the Speaker proposed spending $6700 to pay for a program it would
cost $8000 to maintain; and the caller was so impressed by the
size of the "increase" that she wanted to give some
of it back!

This is the kind of confusion that inevitably arises when analysts
compare budget figures without accounting for inflation; in a
rational universe, it would have been the job of the national
press corps to provide this perspective on the Speaker's presentation.
In a rational universe, the press at this point would have posed
a few simple questions each time the Speaker made his comparison.
What level of service will you provide for $6700, if it will cost
$8000 to maintain the current program? Will it be possible to
maintain current levels of service, or will current services have
to be cut? What level of service can future recipients expect
under terms of the GOP plan? What will the Medicare program look
like in 2002?

But in calendar year 1995, expecting the Washington press corps
to provide technical oversight was like asking Dennis Rodman to
write for Miss Manners. The press would be bullied and badgered
by Gingrich's personal onslaught into reporting the story the
way he liked it. The simple questions the Speaker should have
been asked? They haven't been asked to this day.

In fairness, it should be said that there may be good answers
to the questions the press wasn't asking. Both parties, in their
current budgets, propose spending less money in future years than
it would cost to continue the current Medicare program. But both
parties also propose reforms in the operations of the Medicare
program that are intended to make it more cost-effective. And
it has also been true, over the past number of years, that there
has been an unusually high rate of cost inflation observed within
the Medicare system (which helps explain the CBO's $8000 estimate
for 2002). It may well be that effective reform would help shrink
the rising cost of Medicare services, allowing the Speaker to
provide something resembling the current level of services for
the $6700 in spending he proposed.

But we have never learned what the Speaker would say if he
were asked a few simple questions, because these simple questions
have never been asked by the national press. Over the past two
years, Gingrich has argued that there are no cuts in the Medicare
program, and that "Medicare is increasing" by 40%; and
he has proven his claim with the Gingrich Comparison. And in all
his appearances on network news shows, and in all his appearances
in national forums, no one has ever mentionednot one timethe
problems inherent in the Gingrich Comparison. No one has cited
the problems built into a budget comparison that fails to account
for inflation.

Gingrich went on Meet the Press on November 12, 1995,
and said he would spend $6700 per recipient in 2002. No one mentioned
the CBO estimate of what the current program would actually cost
in that year. He made his comparison on This Week on November
19; no one asked if his figures accounted for inflation. (This
was the first time he proposed spending $7100 instead of $6700.
No one seemed to notice that either.) Throughout calendar year
1995, in fact, Gingrich appeared on Meet the Press three
times; on This Week four times; he regularly appeared on
Face the Nation and TheNewsHour. And in
all those appearances on the nation's top news shows, no one ever
mentioned inflation, or asked about the CBO estimate. The Speaker's
misleading comparison was made in a critical vacuum, with no challenge
from the Washington press.

It's hardly surprising that the public gained a sanguine view
of the Speaker's proposal, given the persistently cheerful presentations
made in the mainstream press. Even when Gingrich himself was not
present, technically unprepared journalists took up his part,
persuading the public that, under his program, "Medicare
will continue to grow."

Case in point: a ballyhooed Nightline of December 12,
1995, in which Ted Koppel and a pair of guests examined the "Mediscare"
phenomenon in which, the show argued, citizens were being needlessly
frightened about "cuts" in the GOP plan. In the course
of the broadcast, no one ever mentioned the CBO estimate, or pointed
out that both parties proposed spending less than it would cost
to maintain the current program. But there did occur this cheerful
exchange, in which the Speaker's misleading presentation was acted
out in his absence:

KOPPEL: All right. So we can actually take the Medicare program
and we can say, "...what you're going to be getting, in terms of dollars
to spend on your health care, if you're over the age of 65, under the Medicare program, you're going to get more under both the Republican and the Democratic plans?"

JAMES GLASSMAN: Oh, you're going to get considerably more...By
the year 2002, you'll get, under both programs, about $7100 or $7200.
Right now the spending in Medicare is about $4700. So that's a big increase.

A "big increase" in dollar spending, unadjusted for
inflation; but not a big enough "increase" to approach
the $8000 it would cost to keep running the existing Medicare
program. That fact, all too typically, Nightline's viewers
were not told.

Can I be the only person who watched the Speaker's appearances
with a growing sense of amazement and concern? Throughout 1995,
Gingrich made his presentation on a succession of news shows,
with no word of challenge from the high-profile panelists. I puzzled
all year as to what could explain their failure to clarify the
Speaker's presentation. Did they not realize the problem with
the Gingrich Comparison? Or did they recognize the flaw with the
Speaker's construct, and not think it was worth bringing up?

Neither possibility seemed imaginable, but there was the Speaker
on national television, repeatedly making his flawed presentation
while network analysts sat mutely by.

A remarkable anecdote casting light on this matter was included
by humorist/commentator Al Franken in Rush Limbaugh is a Big
Fat Idiot, a best-seller combining humor and satire with policy
analysis and personal anecdote. Franken describes Gingrich's performance
at Ross Perot's Dallas convention in August 1995, at which Gingrich
delivered his standard presentation in a typically aggressive
and personal matter. Gingrich, quoted by Franken:

Now most of you probably do math well enough that you know
if you're at 4800 here at you're at 6700 here, that's called an
increase. Now I want to go real slow for a minute because we've
got a lot of reporters who are listening...

Now I don't want to be too negative, but you might even have
one or two liberals who show up who claim that going from 4800
to 6700 is a cut. Now, this is not because they're bad people;
this is an early sign of the educational dysfunction which has
hit our society.

By late 1995, this abusive tonein support of an indefensible
presentationhad become a trademark of the Speaker's appearances
promoting the GOP plan.

After the evening's session, Franken is luxuriating in a Hyatt
lounge with CNN's Robert Novak, NewsHour correspondent
Margaret Warner, and House Budget Committee chairman John Kasich
(R-OH), a key member of the GOP leadership. In challenging Kasich
on the Speaker's argument, Frankena humoristmanages to display
the technical competence which completely eluded the press corps
all year. And this evokes a reaction so remarkable that I reprint
the anecdote in full:

At one point Novak was extolling Gingrich's "masterful"
speech, and I objected, especially to the patronizing crap about
the $4800 versus the $6700. So I turned to Kasich:
"By the way, are those constant dollars?"
Margaret jumped in. "Of course they're constant dollars.
They wouldn't be that dishonest."
"Sure they would," I said. Turning back to Kasich,
"Are those constant dollars?"
"Al..." Kasich's voice has a touch of annoyance, "we're
increasing funding for Medicare."
"But the $4800 to $6700, has that been adjusted for inflation?"
"Al, the dollars are going up."
"I just want to know if those are constant dollars."
"Al, we're going from 178 billion [total Medicare budget
in 1995] to 283 billion [total Medicare budget in 2002]."
Kasich gave the others an exasperated look. When will this guy
stop?
"Look. Gingrich is going like, 'Hey, you're a fucking
moron if you can't see that 6700 is more than 4800.' I just want
to know how big a moron am I. Are those constant dollars?"
A pause. Then. "No, Al, they're not constant dollars."
Kasich slumped in his chair and admitted, "I guess we're
being a little intellectually dishonest about this one."
And I took a few victory laps around the table.
Margaret was slightly embarrassed and begged me not to repeat
the part about her assuming it was constant dollars. I knew she
was kidding, however. She's a terrific journalist and she knows
a good story.

Except this was more than just a good storyit was in fact
a remarkable story, a stunning picture of the sorry state
of Washington journalism, 1995-style. At this point in time, Gingrich
had been making his argument in major forums for a period of roughly
four months; it had clearly become the principal statement of
the GOP case for its Medicare plan. It had also become the principal
explanation of how the GOP could achieve its miracle budgethow
it could balance the budget, give us all a big tax cut, and increase
entitlements by 40%.

Given this background, the idea that the Washington correspondent
for one of the nation's top news programs had not inquired if
the Speaker's plan took account of inflationworse, had simply
assumed that it didis a remarkable example of the technical insouciance
that has characterized press reaction to the Speaker's presentation.
That the journalist was out socializing with one of the plan's
principal sponsorsand was reflexively and inaccurately defending
his honestyis as striking a portrait of a breakdown in
press oversight as we are ever likely to receive.

But if some journalists' technical competence was sadly lackingand
if skeptical instincts were dulled from disuseit should be said
that, by late 1995, scribes were being helped in their intellectual
torpor by an aggressive lobbying campaign from the Speaker's office.
In this effort, the GOP hectored leading journalists as to how
they should present the Medicare story to the public. Incredibly,
the GOP recited the very words and phrases that journalists should
use in telling the tale. And, as reporting from the Washington
Post made quite clear, the press corpssad to saywent along.

III. Script the press

ACCORDING TO DAVID MARANISS and Michael Weisskopf in their
book "Tell Newt to Shut Up," Republican pollsters
in early 1995 were conducting extensive focus group sessions,
trying to find soothing phrases the party could use to describe
its Medicare plan. By this time, many voters were disturbed to
hear that the GOP was planning to "cut" the popular
program. In March 1995, pollster Linda DiVall reported detailed
findings to House GOP leaders about what words and phrases sounded
reassuring to voters, and what words and phrases cast the party's
Medicare proposal in a frightening light.

For example, said DiVall, voters should never be told the party
was "changing" Medicare; they should be told the party
was "preserving" the program. And most important, she
reported, the party should never use the unpleasant word "cut"
when describing its Medicare plan.

The recommendations DiVall gave to party leaders were not based
on hunches or guesswork. DiVall had done careful focus group polling.
According to Maraniss and Weisskopf, DiVall told the leaders exactly
how much they could gain:

Polls by DiVall showed that the public reacted negatively when
told that Republicans would cut Medicare, but positively when
informed that spending would increase but at a slower rate. "The
phrase 'spending would continue to increase but at a slower rate'
is literally 20% to 40% stronger than 'reduce the rate of growth,'
and certainly using the word 'cut,'" [sic] a DiVall memo
stated.

DiVall's recommendations would require significant changes
in the normal language then used by these leaders. The GOP was
proposing spending substantially less than it would cost to maintain
the existing Medicare program; and this was a type of spending
adjustment that had always before been described as a "cut."
The GOP leaders were experienced legislators who always had spoken
that way in the past. Now they agreed to describe their proposal
in new, poll-tested ways in their desire to get improved polling
numbers.

To help school themselves in the party's new language, the
leaders even agreed they would throw a dollar bill into a hat
every time they slipped up and used the word "cut" to
describe their own Medicare program. (According to Maraniss and
Weisskopf, Kasich was first to pay the fine.) So they learned
to stop describing their proposal in the traditional way they
had always used and that seemed most natural; their proposal could
no longer be described this way, because with the public that
produced bad results.

After DiVall's report, there followed an extensive effort in
which GOP leaders lobbied the press on the Medicare story. The
GOP urged the press to use DiVall's words and phrases, and badgered
the press not to use the word "cut" in describing the
GOP plan. Maraniss and Weisskopf describe the process:

[Kasich] pounded away fiercely on the issue, calling reporters
late at night or early in the morning to warn them off the dreaded
word. "I worked them over," he said. [Haley] Barbour
was equally vigilant. He called anchormen at ABC and NBC and a
correspondent at CBS and chided them for using the word. He held
breakfasts and lunches with reporters at his conference table
at the RNC to go over the difference between cuts and slowing
the rate of growth.

Barbour was technically correct. Average spending per Medicare
recipient in the Republican plan rose from $4800 to $6700 in seven
years, numbers that were etched in the minds of every Republican.
But when quality of service was factored in, Democrats scored
big. To provide today's level of service seven years later would
cost $8000 per beneficiary. And premiums for more pensioners would
rise to help generate the huge savings Republicans had envisioned.

A first point: there is nothing automatically wrong, in my
view, with using focus groups to select words and phrases. And
there is nothing wrong with lobbying the press in the manner describedif
the semantic claims being urged are sound. But in this case, the
GOP was pushing claims that had no merit whatever; it is not at
all clear, to use Maraniss' phrase, that Barbour's claims were
"technically correct" at all. In fact, they were uniformly
misleading (see Appendix I). Meanwhile, the GOP was pushing its
claims on a bunch of journalists who have proven to be less than
technical giants, and who were being beaten up badly for "liberal
bias" when they used terms the Speaker's pollsters didn't
like.

Journalists would be ridiculed by Gingrich in his speeches;
meanwhile, when they went on C-SPAN and talked about "cuts,"
viewers would call in and accuse them of lying. And, quite plainly,
no one was lobbying journalists to detail the information that
Maraniss mentioned. No one was lobbying writers to mention the
CBO estimate; no one was calling them liars (or attacking their
"conservative bias") if they didn't mention the $8000
figure (and almost no one ever did). Result: we soon had a national
press corps contorting the language to avoid using language that
offended the Speaker, while virtually never mentioning the fact
that the Speaker's budget figures didn't account for inflation,
or that the GOP was spending $6700 to "preserve" a program
it would cost $8000 to maintain.

Even Maraniss and Weisskopf, whose reporting is invaluable,
seem to show the way reporters now bent their language to serve
the GOP's will. For example, here's how they describe the March
1995 meeting at which DiVall gave GOP leaders their official new
phrasebook:

The speaker's conference room on the second floor of the Capitol
was "filled with high anxiety" that day, as one participant
said later. Everyone understood the perilous circumstances. The
GOP needed to squeeze $270 billion from Medicare to fulfill its
promise of a tax cut and balanced budget in seven years...The odds
appeared unfavorable.

But why did the writers choose to use the word "squeeze,"
rather than its more conventional synonym "cut?" In
the given case, of course, I cannot say, but it was a type of
word choice the press corps began making as the GOP attacked them
when they used the word "cut." Richard Wolf, in USA
Today, on GOP plans for the Medicaid program:

The GOP plan would squeeze an estimated $255 billion from the
projected state and federal Medicaid spending and another $53
billion from projected welfare spending over six years, even though
both programs would continue to grow.

Note the gratuitous way Wolf throws in the GOP's favorite pitch
at the end, although in this context the claim is completely ambiguous.
What about Medicaid will continue to grow? Will Medicaid
services continue to grow? Or just Medicaid dollar spending,
unadjusted for inflation? When used in this sort of context, the
phrase "Medicare/Medicaid will continue to grow" almost
inevitably misleads the reader, but it now began appearing routinely
in the press as journalists worked a favorite phrase from the
GOP phrasebook into every part of the Medicare discourse.

Soon writers were writing about Medicare "savings,"
rather than "cuts;" were using various euphemistic replacements
for the banished word "cut" where they couldn't find
a way to write around the whole concept; and were gratuitously
mentioning how "Medicare would grow," almost always
in ways that were misleading (see Appendix II). Some writers twisted
themselves into pretzels to accommodate the list of approved words
and phrases; listen to Suzanne Fields of the Washington Times
as she works in every phrase from the phrasebook:

Senate Minority Leader Tom Daschle continues to demagogue on
Medicare, too, despite Republican proposals to increase, not decrease,
the growth of the average Medicare premium from $4800 in 1995
to almost $7100 in 2002.

According to the tongue-twisted but ideologically-compliant
Fields, the Republicans were proposing to "increase the growth
of the average Medicare premium." What they were actually
proposing, of course, was to increase the average Medicare premium
(in dollar amounts not adjusted for inflation). But, as a fervent
defender of the Speaker's new language, Fields couldn't resist
trying to work the term "growth" into each and every
formulation, producing a tongue-tied bit of confusion that typified
the way journalists began reworking the language at the direction
of their Republican lords.

The process culminated with Blitzer's question at Clinton's
May 8, 1996 press conference, in which Blitzer reads the riot
act from the GOP playbook to a president who, as we shall see,
has frequently used the term "Medicare cuts" to describe
his own Medicare program. Blitzer is so sure of his new age semantics,
he can't help but confront and expound:

Mr. President, your most recent Clinton-Gore campaign commercials
still speak about Republican cuts in Medicare and Medicaid. Speaker
Gingrich points out repeatedly that these aren't "cuts"
in Medicare and Medicaid; they are simply cuts in the projected
growth of Medicare and Medicaid, which you in your own seven-year
balanced-budget proposal similarly propose.

Are you prepared to stop calling the Republican savings in
Medicare and Medicaid "cuts?"

Touchdown GOP! In the last sentence, a major correspondent
has now told Clinton that the Republicans aren't making "cuts,"
they're just making "savings," parroting the language
that GOP spinners had formulated fourteen months before. In his
formulation, Blitzer enters the GOP fantasy-world in which the
party miraculously achieves "$270 billion in Medicare savings"
without ever making reductions or cuts (see Appendix III); and
achieves a balanced budget, with a big tax cut, by increasing
entitlements 47%! The journalist rises to assert as fact every
poll-tested element of GOP spinasserts, for example, that the
GOP is merely "cutting the growth of the Medicare program"
without mentioning that they are cutting the growth of the program
so much that they propose spending $7100 in the year 2002 on a
program it will cost $8090 to run! Every element the GOP sent
out as spin now emerges as fact in the journalist's mouth, showing
how a determined party hectoring an incompetent press corps can
control the discourseand can rewrite the language.

IV. How to straighten the muddle

Recapping briefly: When the GOP learned that the public
was troubled to hear about "cuts" in its Medicare program,
GOP leaders conducted focus group sessions, looking for ways to
describe their proposals that the public would find less disturbing.

I have said there is nothing wrong with this practiceif it
produces descriptions that are reasonably accurate. But every
element of the new Republican pitch turned out to be misleading.
And, as these representations have come to define our Medicare
discourse, we have reached a point of total confusion, in which
Republicans and Democrats cannot even agree on what the GOP has
proposed.

It is as if the two parties are now speaking two different
languages when they debate the Medicare program. At this point,
absurdly enough, the two parties cannot even agree on whether
the GOP is calling for increases or cuts in the Medicare program.

If we're going to conduct a clear-headed discourse, we must
devise a common language for discussing the two parties' plans.
The good news: for all the confusion of the past several years,
finding a clear way to discuss the Medicare program shouldn't
be hard to do.

In fact, the current state of the Medicare program is remarkably
easy to summarize. I offer three basic statements of fact, and
one question the two parties should be repeatedly asked.

Regarding Medicare:

Fact: Both parties propose spending more in future years
than is currently spent in the Medicare program. This is the fact
to which Republicans refer when they say, "Medicare will
continue to grow."

Fact: Both parties propose spending less in future years
than it will cost to continue the current program. This is the
fact to which Democrats refer when they talk about Medicare "cuts."

Fact: Both parties propose reforms of the Medicare program
intended to make it more cost-effective.

Question: Both parties must be asked: What level of services
will you be able to provide at the level of spending you propose
for the future? Will you be able to maintain current services
at the spending level you propose?

It should have been easy, over the past few years, to build
our discourse around these simple points. There is nothing complex
about the basic fact structure of the Medicare situation at all.

And please note, in reviewing these points: it is possible
to describe the two parties plans without ever once using the
disputed term "cuts." If necessary, the two parties'
plans can be fully described without this term ever being mentioned.

But, as anyone who has watched the Medicare discourse will
know, our discussion inevitably turns into a food fight over whether
GOP proposals should be called "increases" or "cuts,"
with Republicans spinning their poll-driven position, and with
overwrought moderators throwing up their hands and moving on to
the next topic. The result: the first price we have paid for the
Gingrich Comparison has been the hopeless muddling of the Medicare
discourse, in which we have endlessly argued semantic distinctions
and avoided the serious questions that will matter in the end.

To their credit, the Republicans brought forward a major proposal
in 1995, urging major changes in the way we manage the federal
budget. Under the leadership of Speaker Gingrich, they succeeded
in what had come to seem unimaginablethey brought forward a real
balanced budget proposal for the first time in several decades.

Given the degree of change they proposed, it is hardly surprising,
two years later, that there is disagreement about the wisdom
of their plan. But what is truly astounding, two years later,
is the fact that there is still complete and utter failure to
agree on the basic facts of what they're proposing, with Democrats
and Republicans unable to agree on whether the GOP is proposing
increases or cuts.

It augurs poorly for our discourse of the next twenty years
if we can't find a way to do better than this. Our semantic confusion
has to be set right, or we are doomed to a remarkably frustrating
and unproductive time as we try to restructure entitlements.

There are two simple things the press should do in discussing
the two parties' Medicare proposalstwo simple things that have
almost never been done in the chaos of the past two years.

Account for inflation. The press should never present
future spending proposals without making some effort to account
for inflation. It is not enough to compare proposed future spending
to the current amount being spent. To help account for effects
of inflation, proposed future spending should always be compared
to what it will cost to continue the current program.

Avoid obvious ambiguity. In talking about Medicare, Medicaid,
or similar programs, the press should always specify whether it
is talking about dollar spending or level of
servicesan absolutely crucial distinction. It is plainly
ambiguous, and usually misleading, to write a sentence like "Medicare
will grow by 40%." If it is Medicare dollar spending
(unadjusted) that is meant, that fact should always be stated.
Then some effort can be made to estimate the level of Medicare
services that can be provided for the spending that
is proposed.

How would the past two years' debate have turned out, with
press and moderators observing these rules? Here is how the standard
Crossfire-style discussion might have turned out, had moderators
played by these rules:

REPRESENTATIVE DEMOCRAT: Crazy! The Republicans are cutting
Medicare by $270 billion in their seven-year plan! That is an
amount that goes well beyond what is needed to balance the budget
and would gut the Medicare system!

REPRESENTATIVE REPUBLICAN: There they go again, Mr. Moderator!
My good friend says we are cutting Medicare to the bone; but there
are no cuts in our Medicare program at all. Under our plan, Medicare
spending, per senior citizen, goes from $4800 in 1995 to $6700
in 2002. That's an increase, that isn't a cut.

MODERATOR: But your own CBO estimates it will cost $8000 per
recipient in 2002 just to maintain the current program. How will
you provide the current level of services? Can you provide
the current level of services, spending $6700 in 2002?

At this point, Rep. Republican would have had to explain how
his reforms would make Medicare more cost-effective, and estimate
the level of services his plan could provide in future years.
(Rep. Democrat would have to project how his plan would
work, too.) Health policy experts could then have come in, to
evaluate the two parties' projections, and observers would then
have some reasonable basis on which to evaluate the two parties'
plans.

This intervention by a skilled moderator would not produce
a perfect discourse. Claims about the future workings of the two
parties' programs would inevitably involved imperfect projections
and estimates. And Medicare is a complex, multi-faceted program,
not susceptible to simple description.

But this discussion would be a massive improvement over the
miserable debate of the past two years. Citizens would know how
much money each party would spend on the program, and what level
of services each plan might provide. Most important, citizens
would realize that we are struggling here to maintain current
servicesnot looking forward to the "47% increase" in
Medicare services many citizens thought Gingrich was describing.

A final note about this discussion: at no point after the moderator's
intervention would semantic disputes ever have to intrude. After
the moderator's intervention, the two parties' plans can be fully
discussed without the word "cuts" ever having to be
used. I myself do not have a problem with saying the two parties'
Medicare plans involve "cuts." But if one participant
has an objection, the two parties' plans can be fully debated
without the vile term being used.

But it is also possible, if we observe my suggestions, that
we will avoid the second major price we have paid for allowing
the rise of the Gingrich Comparison. That second price is the
damage done to the civility of our discourse by the constant,
relentless, demagogic charge that President Clinton has been deceiving
the public when he talks about Medicare "cuts."

V. Clinton speaks

THE CHARGE HAS BEEN REPEATED, AGAIN AND AGAIN, by the Speaker
and his associates. President Clinton is deceiving the public
when he talks about GOP "cuts."

When a Speaker condemns a president in such striking language,
one would think it would be a major press story, with the charges
subjected to the closest review. And one would think a Speaker
would be held to high standards of evidence when he makes so aggressive
a charge.

But of all the things the press has failed to observe in its
hapless pursuit of the Medicare story, one of the most striking
is this: the White House has frequently used the term "Medicare
cuts" to describe its own program as well as the GOP plan.
The same terms that the White House has applied to the GOP plan,
it has also applied to its own.

During one five-week period this past spring, for example,
three major White House spokesmen, on three major news shows,
all used the term "Medicare cuts" to describe their
own plan. The same term they applied to the GOP program, they
unambiguously applied to their own.

For example, on CNN's May 5 Late Edition, Treasury Undersecretary
Lawrence Summers described the White House budget plan:

We've got a budget on the tableseven years, CBO, entitlement
cuts, with tax cuts, with large expenditure reductions, with
middle-class tax cuts of the kind [the Republicans] favor...

CNN's semantically-correct Frank Sesno asked Summer to elaborate
on the "Medicare savings" in the two parties' plans.
Summers said this of the White House proposal:

The administration's had $124 billion in cuts on the
table. The problem is that the Republican majority has insisted
on a whole set of other steps that would raise premiums...

Perhaps this use of the term "cuts" to describe the
White House plan was merely the work of a bumbling undersecretary.
Sorryhere's Laura Tyson, chair of the president's Council of
Economic Advisers, on PBS' NewsHour June 6:

ELIZABETH FARNSWORTH: Very briefly, Miss Tyson, run through
the essentials of the Democratic [Medicare] plan.

TYSON: The essentials of our planessentially, we have put
on the table $124 billion of cuts in Medicare. Again, that
has been certified by the Congressional Budget Office in that
amount, and also as balancing the budget.

And here's Treasury Secretary Robert Rubin, on ABC's This
Week, asked about Medicare on June 9:

DAVID BRINKLEY: Here's a question you haven't had before. Medicare
is in serious financial trouble, going broke in five years we're
told. I'm also told that 40% of the cost is paper-shuffling. Is
that true? Could that be true?

RUBIN: Well, that is a part of the problem...and that is why the
president has consistently said, and rightly so, that you can
put in place a program that will extend the trust fund by ten
years to the middle of the next decade with the kinds of cutsreductionshe
has proposed without having an adverse effect on the elderly.
The program that [previous guest] Dick Armey referring to, that
the president vetoed, was a $270 billion reductioncutin Medicare,
most of which was absolutely unnecessary.

While the White House has been endlessly accused of lying for
referring to "cuts" in the GOP program, quite plainly
these spokesmen were using the same terms to describe their own
Medicare plan. Nor is this different from the language which Clinton
has used to describe his own Medicare program. For example, here
is Clinton at a major January 9, 1996 press conference, just as
the extended budget talks between the White House and the congressional
leaders were nearing their unfruitful end:

Good afternoon. As you know, we have just completed another
long meeting with the Republican and Democratic leaders in the
Congress. We have arrived at a point where, clearly, all sides
have agreed on enough cuts to both balance the budget in seven
years...and allow a modest tax cut.

Given the limited number of program that had been on the table
in the talks, the president here has a clearly said that both
parties have agreed to make Medicare cuts. His next sentence makes
the point even plainer:

Unfortunately, the talks have not yet succeeded because we
do still disagree on the level of cuts in the programs of Medicare
[and] Medicaid...

The Republicans still want cuts in Medicare and Medicaid that
we believe are well beyond what is necessary to balance the budget.

The problem here, quite plainly, is not that the Republicans
are cutting Medicare and the Democrats are not. The problem is
that the Republicans are cutting the program too muchmore than
is needed to balance the budget. But it remains quite clear throughout
the president's conference (and at a follow-up conference on January
11) that Clinton is freely asserting that both parties propose
large spending cuts:

Neither of these budgets is a big-spending budget. Both these
budgets will require steep cuts in spending.

Nor is Clinton reluctant to use the GOP's preferred term, "Medicare
savings," in a plainly bipartisan manner:

I want to keep working together...I am very much hoping that we
can make this agreement. It will; require us to make some more
steps to bridge this gap, but we have agreed to well over, way
over $600 billion in savings, more than enough to balance the
budget.

Two days later, in a remarkably inaccurate nationally televised
press conference, Gingrich harshly assailed Clinton for the language
of Clinton's press conference. He specifically accused Clinton
of using the word "cuts" to refer to the GOP plan only,
and of using the word "savings" to describe only the
White House plan. He repeatedly cited the president's "dishonesty"
in the use of those terms as the reason why the ongoing budget
talks would not likely succeed.

The Speaker's description of Clinton's January 9 press conference
was baldly and demonstrably false. No one could read the January
9 transcript without noting the striking inaccuracy of the Speaker's
remarks. But, despite the importance of the occasion, and the
significance the Speaker gave to his charge, the reliably somnolent
Washington press corps took absolutely no note of the Speaker's
misstatements. Four months later, Blitzer rose in the White House
to challenge the president for referring to GOP Medicare "cuts,"
apparently unaware, right up to that day, that the offending term
was being used by the White House to describe its own Medicare
program.

Most people, I would think, would find it odd to see a president
called a liar on a basis like thisfor using traditional terms
to describe a GOP program, language he was also using to describe
his own plan.

But it is particularly striking to see Gingrich attack the
president on this matter because, at the time that the Speaker
began making this charge, it had been only a few months since
Gingrich himself had spoken openly about GOP "cuts."
Before Linda DiVall gave her poll-driven warning that the GOP
should never use the troubling word "cuts," that is
precisely the way the Speaker had spoken about the Republican
Medicare plan.

On October 2, 1994four weeks before the election that would
make him the SpeakerGingrich appeared on Meet the Press
to discuss the controversial "Contract with America."
Working with a chart that showed projected federal spending in
2002 (and a projected $319 billion federal deficit), Tim Russert
asked Gingrich what spending he would cut to balance the budget,
and the future Speaker seemed quite at ease with the language
of entitlement cuts:

RUSSERT: Congressman Gingrich, if I could talkif you couldlooking
at this chartthis is the ear 2002, where you said you [will]
have a balanced budget. Could you explain our viewers what area
of the budget you could seek cuts in?

GINGRICH: Sure, I would say to our viewers that we have to
look at transforming virtually every area of the budget except
Social Security...You've got to look at defense, you've got to look
at law enforcement, you've got to look at every entitlement.

Continuing, Russert pressed Gingrich specifically: could he
balance the budget without entitlement cuts?

RUSSERT: What I'm asking you very specifically is, can you
balance the budget without making entitlement cuts?

GINGRICH: The answer, of course, is no. That's a nonsense question.
The fact is, we're going to have to change entitlements dramatically.

And that's the way the Speaker spoke before he learned to mouth
the misleading phrases of the new Medicare languagebefore he
gimmicked up a bunch of phrases that made it sound as like he
had found a way to balance the budget by "increasing Medicare
40%." That is the way the Speaker spoke before a pollster
told him he had to stop saying the word "cuts"and before
he decided it would help all around if he also called Clinton
a liar.

At a time when so many people are so concerned about civility
in our public discourse, I think most people would be quite surprised
to see that a president can be attacked as a liar on a basis like
this. Let's just borrow from John Kasich's wordsapparently the
Speaker and his allies decided to be "a little intellectually
dishonest" when it came to this one, also.

VI. Conclusion

When the GOP decided, in March 1995, that no one should use
the term "Medicare cuts," they were in fact creating
a new micro-language, one very different from the one used before.
In 1995, both parties proposed spending less in future years than
it would cost to continue the existing Medicare program. This
would not only mean reduced future spending; this would like mean
a reduction in services too. And this was a type of proposal that,
reasonably enough, had always been described as a "cut."

This was not the language that had been used by dishonest Democrats,
or by big-spending liberals, or by spin-doctors out to bamboozle
the public. This was the language that everyone had used to describe
proposals like the GOP made. The old language seemed most natural
to Republicans too, so much so that Republicans had to train themselves
to speak the new language, fining themselves a dollar a pop every
time they slipped up and said "cuts."

Important note: the GOP was not suggesting that we all speak
the new language because they had learned that the old language
was misleading the public. Linda DiVall had told them something
quite differentthat more voters would favor the GOP plan if the
word "cuts" was never used to describe it. The GOP had
decided to drop the old language because the new language gave
better spin.

In fact, as I have shown, the new language that the GOP used
deeply misled the public; people thought they were being promised
increases in Medicare services when no such proposal had ever
been made. But clarity had not been the GOP goal; the GOP goal
was improved polling numbers. So the GOP called up the nation's
reporters and told them to speak a misleading new language; and
when the White House continued to speak the old language, they
were denounced by the Speaker as liars.

When the GOP said "there are no cuts," they meant:
we'll spend more in the future than we're spending this year.
When the Democrats talked about Medicare cuts, they meant: we're
spending less in the future than the current program will cost.
It would have been easy enough to straighten out the confusion,
had the press corps stepped in with some competent oversight.
But that was beyond the press corps' grasp. Like the impressionable
citizens of a mythical empire who had once marveled at an emperor's
new suit of clothes, the press corps was mouthing the misleading
new phrases that went to make up The Speaker's New Language.

The result? Two years after a landmark proposal, the public
cannot agree on simple facts about what was proposed. The public
is now speaking two different languages, and our public discourse
is in a complete mess.

I have tried to show a few simple ways to straighten out this
absurd muddle. We'll be talking entitlements for the next twenty
years. It would help if we spoke the same language.

(Appendices follow)

Appendix I
Lexicon: a summary of misleading phrases in the GOP's new
Medicare language

Listed below are phrases commonly used by the GOP to describe
and defend its Medicare plan. All are potentially misleading.

There are no cuts in our Medicare program. This has
often been taken to mean that there will be no cuts in Medicare
services. There is no such pledge in the GOP plan.

Medicare will continue to grow. Again, this has been taken
to mean that Medicare services will continue to grow. The reference
is actually to Medicare dollar spending, unadjusted for effects
of inflation.

Medicare will grow by 47%. This has often conjured an image
of Medicare services growing even faster than citizens want them
to. Reality: there is no guarantee that the GOP can even maintain
current services at the level of spending it proposes.

Medicare will grow, but at a slower rate/We're only cutting
the rate at which Medicare will grow. Fact: the GOP is "cutting
the rate of growth" so fast that it may not be able to maintain
the current level of services.

The Gingrich Comparison:Medicare spending (per recipient)
goes from
$4800 in 1995 to $6700 in 2002. In dollar amounts not
adjusted for inflation.
The CBO estimates it will cost $8000 per recipient
in 2002 to maintain the
current program.

Appendix II
Reigning king of the Medicare euphemists: Clay Chandler, the
Washington Post

When the GOP decided it couldn't afford to have its Medicare
plan described as a "cut," it began pressuring journalists
to avoid use of the term when writing about the Republican program.

Compliant writers began looking for ways to describe the plan
without offending their Republican lords.

As the months have gone by, the press corps has developed remarkable
skill at the practice of Medicare euphemism. We hail this defining
performance by the Washington Post's Clay Chandler (8/24/96):

The budget plan approved by congressional Republicans this
year nibbled at entitlements, proposing Medicare spending
be curbed by $168 billion over six years. The Clinton budget
envisioned even smaller Medicare reductions of about $116 billion.

But neither [presidential] candidate has dared squeeze
the program farther...

Republicans "nibble at," "curb," and "squeeze"
the program, but they are never said to "cut" it. The
word "cut" never appeared in Chandler's article, except
in a paraphrase of Clinton's statements about the GOP plan. The
word "reduction" can apparently be used, but only in
direct reference to Clinton's plan.

Question: it is clearly implied in the first paragraph above
that Chandler considers the GOP plan a "reduction."
In what sense, then, is it not a "cut?" And if the GOP
Medicare plan is a cut, why go to such lengths not to say
so?

Appendix III
GOP achieves "savings" without making "cuts!"
The silliest part of The Speaker's New Language

In their 1995 budget proposal, the GOP proposed reducing projected
Medicare spending for each year from 1996 through 2002. The total
reductions that they proposed: $270 billion.

In the press, this was sometimes referred to as "$270
billion in Medicare cuts," because it was the total amount
by which the party would reduce projected spending. It was sometimes
referred to as "$270 billion in Medicare savings," because
that was the amount the tax-payers would save, compared to the
existing projections.

But "Medicare savings" sounds like something you'd
like, and "Medicare cuts" sounds like something you
wouldn't. Therefore, although you can't get one without the other,
the GOP began lobbying the press corps only to refer to their
adjustments as "Medicare savings."

The lapdog press corps rushed to comply, and the expression
"Medicare cuts" largely dropped from view. And when
Wolf Blitzer addressed President Clinton at the White House on
may 8, he specifically asked him: "Are you prepared to stop
calling the Republican savings in Medicare and Medicaid 'cuts?'"

How the GOP had managed to achieve $270 billion in Medicare
savings without making any Medicare cuts was one of the questions
the president may have pondered when his time with the press corps
was finished.

Appendix IV
Reigning king of the Medicare fantasists: David Frum, the
Weekly Standard

Fantasists have come up with creative new ways to pretend there
are no Medicare "cuts" in the GOP budget. In a Weekly
Standard article of 9/9/96, David Frum reached a whole new level.
He wrote:

What Democrats mean by the word "cut," as we all
have learned by now, is not what ordinary budget-makers mean...What
they mean by a "cut" is any change that will deny [Medicare's]
constantly-expanding number of beneficiaries the same generous
level of services that beneficiaries have enjoyed in the past.

Dropping the words in Frum's statement that principally exist
to heighten the spin, this is the statement with which we are
left:

What Democrats mean by a Medicare "cut" is any change
that will deny Medicare recipients the same level of services
that others have received in the past.

And yes, in fact, without any doubt, that's what Democrats
almost surely regard as a "cut." A "cut" is
when next year's Medicare recipients get fewer services than this
year's did! The reduction in services may be good policy; it may
be all we can sensibly afford. But yeswhen next year's recipients
get fewer services, that is a "Medicare cut."

Incidentally, Frum is precisely wrong in his principal statement,
as we show in the present article. The GOP's Medicare proposal
is a type of proposal that has always been referred to
as a "cut." As we show, Republican leaders had to train
themselves to stop using the word when describing their own Medicare
proposal.